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Shisha - don't be fooled

Birmingham Public Heath, in partnership with Birmingham City Council (Regulation and Enforcement) is working to increase awareness, amongst users, of the health effects of using shisha. Part of the awareness campaign is an educational DVD which is being used at health events, in GP surgeries and is available with a wealth of other information on this important subject at:

Shisha (hookah or Hubble bubble), is a form of smoking traditional to the Middle East and Asia and its popularity within the United Kingdom has increased in recent years. It is a sociable activity where people sit together and pass the shisha pipe amongst the group so they can enjoy the experience together. Shisha smoking can now be found within the home or within shisha businesses.

Shisha is smoking a substance which is tobacco flavoured with molasses or sugar cane juice and dried fruit, so the smoke has a sweet smell and a taste. This substance is burnt over lit charcoal and the smoke passes through a liquid, to cool down the smoke, before it is inhaled through a pipe by the consumer.

Shisha smoking is on the increase in the city of Birmingham, and although illegal until the age of 18, it is common practice for parties to take place where under 18’s are in attendance.

Contrary to user’s belief, the effects of smoking shisha are deemed more harmful than smoking cigarettes because the liquid in the pipes does not act as a filter for the harmful toxins within the smoke from the tobacco and charcoal. Shisha smoke can contain carbon monoxide, nicotine, arsenic, and lead.

World Health Organisation (WHO) research shows that in one hour a water pipe smoker can inhale the equivalent amount of smoke as released by 100 cigarettes.

In addition, there are health implications from sharing the pipe, including a risk of catching TB, herpes and gum disease and the risk of passive smoking.

Shisha is smoked now by all sectors of the community and by both men and women, young and old. Users do not always recognise the risks of smoking shisha or deem it as smoking in the same way as smoking cigarettes. Many of the smokers are young people and it is also thought that if they start smoking shisha there is a very high probability that they will become cigarette smokers.

Pregnant women who smoke shisha may also be unaware of the health risks to themselves or their unborn baby.

Shisha premises are not exempt from the smoke free legislation. Shisha is therefore smoked outside, predominantly in elaborate shelters which have to be 50% open to the air. Shisha business are different from other businesses as they encourage customers to stay in the external smoking area for extended periods of time by providing furniture, heating, lighting, entertainment and refreshments. Officers are working extensively with these businesses and in partnership with Fire Safety Officers to ensure they are compliant with all legislation.